Pain Medication

Back pain is a prevalent health concern in the United States and around the world. In fact, almost 65 million Americans have had a recent episode of back pain. 

Thankfully, most back pain episodes can be successfully resolved with at-home care. But, if this approach doesn’t relieve your back pain after a few weeks, you should consult with a back pain specialist.

A specialist may recommend medication for back pain to improve your symptoms. There are several different types of medications that can alleviate back pain, all of which we’ll discuss below. 

Understanding Back Pain

Before we dive into the topic of medication for back pain relief, let’s answer some of the most commonly asked questions about back pain. 

How long does back pain last?

Back pain can be either acute or chronic. Acute back pain typically develops suddenly and resolves within four weeks. However, many cases of acute back pain go away within just a couple of days. 

Chronic back pain lasts for 12 weeks or longer. Patients with chronic back pain may experience temporary pain relief, followed by a flare-up. 

Back pain cases lasting between four and 12 weeks are considered subacute. This means that while the pain lasts longer than acute pain, it’s not defined as chronic. 

How do I know if my back pain is serious?

Back pain may be a sign of a more serious condition if:

• The pain becomes gradually worse over an extended period
• You’re experiencing neurological symptoms, such as tingling, numbness, and weakness in the extremities
• The pain began after an accident, such as a car accident or fall, and has continued to get worse
• The pain interferes with your quality of sleep
• You’re experiencing changes in bladder and/or bowel function (this rare symptom can indicate a severe condition that may cause permanent nerve damage and requires emergency medical attention)

Generally, if you’re experiencing back pain that hasn’t improved at all after two weeks of at-home care, we’d recommend scheduling a medical evaluation. 

How do I know if my back pain is muscle or spine?

Back pain can stem from a wide range of factors. Muscle strains and spasms are common causes of acute back pain and often resolve without medical intervention. Muscular back pain may feel like:

• Soreness after physical activity
• Spasms or cramps
• Sharp or achy pain that’s limited to one area of the back

Spinal problems, on the other hand, tend to require expert medical treatment. Conditions such as a slipped disc, spinal stenosis, spondylosis, and spondylolisthesis can trigger persistent back pain.

Unlike muscular pain, spinal problems can cause neurological symptoms, including numbness, tingling, and weakness in the extremities. Additionally, back pain stemming from the spine generally won’t improve with rest, although changing positions may provide some relief. 

Cases of back pain caused by a spinal condition may require surgical spinal solutions if conservation treatment methods fail after several months. 

Why is my back pain getting worse?

If your back pain is continuing to get worse despite self-care and at-home treatment, you may have a more serious condition, rather than an acute injury. Spinal arthritis, herniated disc, and spinal stenosis are among the most common causes of chronic back pain. 

What does a slipped disc in the back feel like?

A slipped disc occurs when one of the intervertebral discs that cushion the vertebrae is injured. Specifically, the jelly-like disc interior presses out through a crack in the disc’s tough outer shell. If the damaged disc presses on nearby nerves, you may experience a range of symptoms, including:

• Sharp back pain that worsens with activity and may improve when you’re lying down
• Pain that radiates into the arm or leg, depending on the location of the slipped disc
• Numbness, tingling, and/or weakness in the extremities

What Decreases Back Pain?

Most back pain improves with a few weeks of self-care and at-home remedies. This may include over-the-counter pain relievers, ice, heat, and rest. While you should avoid lifting heavy objects and vigorous exercise, gentle, low-impact exercise and moving throughout the day can also help relieve back pain.

While it may seem like sitting and lying down will help relieve your pain, it can actually make it worse by increasing tension in the back muscles. Additionally, movement improves circulation, which helps deliver healing nutrients and oxygen to the back.

Along with these at-home remedies, the following non-invasive and alternative treatments can help decrease back pain:

• Physical therapy
• Chiropractic care
• Acupuncture
• Massage therapy 

What Medicine Can Cure Low Back Pain?

Over-The-Counter Pain Medication For Back Pain

The most common first step in using medication to alleviate back pain is taking over-the-counter medicine. Typically, this involves acetaminophen, such as Tylenol, or NSAIDs (non-steroidal anti-inflammatory drugs). Aspirin, ibuprofen (such as Advil and Motrin), and naproxen (such as Aleve) are widely used for back pain management. 

These medications are often effective at relieving back pain and can work within a very short period. However, make sure to always consult the medication label and/or ask your doctor about the best dose of these lower back pain medications for your needs. 

Taking too high a dose of over-the-counter pain medications, or taking them for an extended period, can trigger side effects including:

• Liver damage
• Increased risk of heart attack and stroke
• Increased risk of bruising and bleeding
• Gastrointestinal issues including upset stomach and peptic ulcers
• Skin reactions

Additionally, you may not be a candidate for over-the-counter pain relievers if you have a history of heart disease, high blood pressure, peptic ulcer disease, gastrointestinal problems, kidney disease, or liver cirrhosis. 

Muscle Relaxant Medication For Lower Back Pain

If over-the-counter medications don’t relieve your back pain issues, your doctor may also prescribe a muscle relaxant. This type of prescription medication for back pain has proven to be effective for many patients and can help manage secondary pain, such as sore hips. 

While muscle relaxants will often lessen back pain, they can cause side effects like sleepiness and dizziness. So, you should take them only when you’re done driving for the day. Ideally, you should only take muscle relaxants when you’re at home and can fully relax.

Don’t take muscle relaxants when you’re at work, have to make important decisions, cook, or complete any other tasks that require focus. Additionally, only take them when you can be sure that someone is available to care for your kids and pets.

Some patients are more sensitive than others to the effects of muscle relaxants and can’t function safely while on this particular type of back pain medication. Your physician will help determine if muscle relaxants are the right choice for you. 

Medication For Severe Back Pain

Narcotics

Your doctor may also prescribe you a narcotic, such as codeine or hydrocodone, as a chronic back pain medication. These medications aren’t prescribed to everyone because they present several risks, including the risk of addiction. Your physician will likely try several other courses of treatment before resorting to narcotics for back pain. 

With this in mind, narcotics should be used only for a short period and with close doctor supervision. Take these lower back pain relief medications only as prescribed and be mindful of side effects including:

• Drowsiness
• Nausea and vomiting
• Impaired judgment
• Slowed breathing
• Constipation
• Addiction, as mentioned above

Antidepressants

Interestingly, some back pain patients experience chronic back pain relief from low doses of certain types of antidepressants. Tricyclic antidepressants such as amitriptyline, in particular, have been beneficial for some back pain patients.

While you may not feel depressed or show other signs of depression, antidepressants are among the arsenal of low back pain medication that your physician may recommend.

Side effects of antidepressants can include:

• Dry mouth
• Constipation
• Unexplained weight gain
• Drowsiness
• Sexual dysfunction
• Difficulty urinating
• Blurred vision

Cortisone Injections

Cortisone injections are another treatment option for severe back pain. These anti-inflammatory and pain-relieving injections are delivered directly to the space around your spinal cord.

Your doctor might inject cortisone into the facet joints of your vertebrae. This can decrease inflammation in the areas causing your back pain, allowing for a fuller range of motion and greater stability. Additionally, a cortisone injection can decrease inflammation around the nerve roots, potentially providing back pain relief for up to a few months after the injection.

Unfortunately, cortisone injections don’t support the body’s healing process or accelerate recovery. In fact, if a patient receives too many of these injections, they can cause tissue damage. For this reason, physicians recommend no more than three to four cortisone injections per year.   

What Is The Best Medication For Back Pain?

Ultimately, the best medication for back pain relief will vary from patient to patient. So, talk to your doctor about which medications may be ideal to relieve your back pain.

Additionally, don’t hesitate to request information on possible side effects and how long you should take each type of suggested medication. It’s crucial to closely follow your physician’s instructions to relieve your back pain with over-the-counter or prescription medications.